The pathogenesis of mucositis: updated perspectives and emerging targets

doi:10.1007/s00520-019-04893-z

Review

. 2019 Oct;27(10):4023-4033.

doi: 10.1007/s00520-019-04893-z. Epub 2019 Jul 8.

The pathogenesis of mucositis: updated perspectives and emerging targets

J Bowen¹, N Al-Dasooqi², P Bossi³, H Wardill², Y Van Sebille⁴, A Al-Azri⁵, E Bateman², M E Correa⁶, J Raber-Durlacher⁷, A Kandwal⁸, B Mayo⁴, R G Nair⁹, A Stringer⁴, K Ten Bohmer¹⁰, D Thorpe⁴, R V Lalla¹¹, S Sonis¹², K Cheng¹³, S Elad¹⁴; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)

Affiliations

¹ Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia. joanne.bowen@adelaide.edu.au.
² Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
³ Department of Medical and Surgical Specialties, Radiological Sciences and Public Health - Medical Oncology, University of Brescia, ASST-Spedali Civili, Brescia, Italy.
⁴ Division of Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia.
⁵ Dental and OMFS Department, Oral Pathology and Medicine, Al-Nahdha Hospital, Ministry of Health, Muscat, Oman.
⁶ Hematology and Blood Transfusion Center, University of Campinas, Campinas, Brazil.
⁷ Department of Oral and Maxillofacial Surgery, Amsterdam UMC, and Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands.
⁸ Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayn University, Dehradun, Uttarakhand, India.
⁹ Oral Medicine, Oral Oncology, Oral Pathology and Human Diseases, Griffith University, Hematology and Oncology, Gold Coast University Hospital, Southport, Queensland, Australia.
¹⁰ Oral medicine, Academic Centre Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, Netherlands.
¹¹ Section of Oral Medicine, University of Connecticut Health, Farmington, CT, USA.
¹² Harvard School of Dental Medicine, Brigham and Women's Hospital and the Dana-Farber Cancer Institute, Boston, MA, USA.
¹³ Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹⁴ Department of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.

PMID: 31286231
DOI: 10.1007/s00520-019-04893-z

Review

The pathogenesis of mucositis: updated perspectives and emerging targets

J Bowen et al. Support Care Cancer. 2019 Oct.

. 2019 Oct;27(10):4023-4033.

doi: 10.1007/s00520-019-04893-z. Epub 2019 Jul 8.

Authors

Affiliations

¹ Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia. joanne.bowen@adelaide.edu.au.
² Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
³ Department of Medical and Surgical Specialties, Radiological Sciences and Public Health - Medical Oncology, University of Brescia, ASST-Spedali Civili, Brescia, Italy.
⁴ Division of Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia.
⁵ Dental and OMFS Department, Oral Pathology and Medicine, Al-Nahdha Hospital, Ministry of Health, Muscat, Oman.
⁶ Hematology and Blood Transfusion Center, University of Campinas, Campinas, Brazil.
⁷ Department of Oral and Maxillofacial Surgery, Amsterdam UMC, and Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands.
⁸ Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayn University, Dehradun, Uttarakhand, India.
⁹ Oral Medicine, Oral Oncology, Oral Pathology and Human Diseases, Griffith University, Hematology and Oncology, Gold Coast University Hospital, Southport, Queensland, Australia.
¹⁰ Oral medicine, Academic Centre Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, Netherlands.
¹¹ Section of Oral Medicine, University of Connecticut Health, Farmington, CT, USA.
¹² Harvard School of Dental Medicine, Brigham and Women's Hospital and the Dana-Farber Cancer Institute, Boston, MA, USA.
¹³ Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹⁴ Department of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.

PMID: 31286231
DOI: 10.1007/s00520-019-04893-z

Abstract

Mucositis research and treatment are a rapidly evolving field providing constant new avenues of research and potential therapies. The MASCC/ISOO Mucositis Study Group regularly assesses available literature relating to pathogenesis, mechanisms, and novel therapeutic approaches and distils this to summary perspectives and recommendations. Reviewers assessed 164 articles published between January 2011 and June 2016 to identify progress made since the last review and highlight new targets for further investigation. Findings were organized into sections including established and emerging mediators of toxicity, potential insights from technological advances in mucositis research, and perspective. Research momentum is accelerating for mucositis pathogenesis, and with this has come utilization of new models and interventions that target specific mechanisms of injury. Technological advances have the potential to revolutionize the field of mucositis research, although focused effort is needed to move rationally targeted interventions to the clinical setting.

Keywords: Microbiome; Mucositis; Pathogenesis; Permeability; Perspectives; Technology.

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References

1. Al-Dasooqi N, Sonis ST, Bowen JM, Bateman E, Blijlevens N, Gibson RJ, Logan RM, Nair RG, Stringer AM, Yazbeck R, Elad S, Lalla RV, Mucositis Study Group of Multinational Association of Supportive Care in Cancer/International Society of Oral O (2013) Emerging evidence on the pathobiology of mucositis. Support Care Cancer 21:2075–2083 - DOI - PubMed
1. Anthony L, Bowen J, Garden A, Hewson I, Sonis S (2006) New thoughts on the pathobiology of regimen-related mucosal injury. Support Care Cancer 14:516–518 - DOI - PubMed
1. Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M, Bekele BN, Raber-Durlacher J, Donnelly JP, Rubenstein EB, Mucositis Study Section of the Multinational Association for Supportive Care in C, and International Society for Oral O (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100:1995–2025 - DOI - PubMed
1. Sixou JL, de Medeiros-Batista O, Bonnaure-Mallet M (1996) Modifications of the microflora of the oral cavity arising during immunosuppressive chemotherapy. Eur J Cancer B Oral Oncol 32B:306–310 - DOI - PubMed
1. Donnelly JP, Bellm LA, Epstein JB, Sonis ST, Symonds RP (2003) Antimicrobial therapy to prevent or treat oral mucositis. Lancet Infect Dis 3:405–412 - DOI - PubMed

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[1] Al-Dasooqi N, Sonis ST, Bowen JM, Bateman E, Blijlevens N, Gibson RJ, Logan RM, Nair RG, Stringer AM, Yazbeck R, Elad S, Lalla RV, Mucositis Study Group of Multinational Association of Supportive Care in Cancer/International Society of Oral O (2013) Emerging evidence on the pathobiology of mucositis. Support Care Cancer 21:2075–2083 - DOI - PubMed

[2] Al-Dasooqi N, Sonis ST, Bowen JM, Bateman E, Blijlevens N, Gibson RJ, Logan RM, Nair RG, Stringer AM, Yazbeck R, Elad S, Lalla RV, Mucositis Study Group of Multinational Association of Supportive Care in Cancer/International Society of Oral O (2013) Emerging evidence on the pathobiology of mucositis. Support Care Cancer 21:2075–2083 - DOI - PubMed

[3] Anthony L, Bowen J, Garden A, Hewson I, Sonis S (2006) New thoughts on the pathobiology of regimen-related mucosal injury. Support Care Cancer 14:516–518 - DOI - PubMed

[4] Anthony L, Bowen J, Garden A, Hewson I, Sonis S (2006) New thoughts on the pathobiology of regimen-related mucosal injury. Support Care Cancer 14:516–518 - DOI - PubMed

[5] Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M, Bekele BN, Raber-Durlacher J, Donnelly JP, Rubenstein EB, Mucositis Study Section of the Multinational Association for Supportive Care in C, and International Society for Oral O (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100:1995–2025 - DOI - PubMed

[6] Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M, Bekele BN, Raber-Durlacher J, Donnelly JP, Rubenstein EB, Mucositis Study Section of the Multinational Association for Supportive Care in C, and International Society for Oral O (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100:1995–2025 - DOI - PubMed

[7] Sixou JL, de Medeiros-Batista O, Bonnaure-Mallet M (1996) Modifications of the microflora of the oral cavity arising during immunosuppressive chemotherapy. Eur J Cancer B Oral Oncol 32B:306–310 - DOI - PubMed

[8] Sixou JL, de Medeiros-Batista O, Bonnaure-Mallet M (1996) Modifications of the microflora of the oral cavity arising during immunosuppressive chemotherapy. Eur J Cancer B Oral Oncol 32B:306–310 - DOI - PubMed

[9] Donnelly JP, Bellm LA, Epstein JB, Sonis ST, Symonds RP (2003) Antimicrobial therapy to prevent or treat oral mucositis. Lancet Infect Dis 3:405–412 - DOI - PubMed

[10] Donnelly JP, Bellm LA, Epstein JB, Sonis ST, Symonds RP (2003) Antimicrobial therapy to prevent or treat oral mucositis. Lancet Infect Dis 3:405–412 - DOI - PubMed

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The pathogenesis of mucositis: updated perspectives and emerging targets

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The pathogenesis of mucositis: updated perspectives and emerging targets

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